In 2014, Congress responded to the Phoenix VA scandal with much-needed legislation — the Veterans Access, Choice and Accountability Act.

This law created the Veterans Choice Program, which sought to give veterans more options over where they access their health care. If the drive times to a VA facility or wait times for an appointment fell outside standards set by the VA, veterans would have the freedom to choose non-VA doctors.

But the Veterans Choice Program was an interim solution to address an immediate need for health care flexibility. The program had many flaws, including its arbitrary criteria for accessing non-VA care and difficulty in paying non-VA providers.

More was needed to build on the ideas and successes of the Veterans Choice Program while addressing its pitfalls.


VA MISSION Act gives more veterans more options than the Veterans Choice Program

The 2018 VA MISSION Act took veterans’ choice over their health care much further, expanding access to non-VA care and creating avenues for the VA to modernize and streamline its services. Major tenets of the law included:

  • New standards for accessing non-VA care that expanded community care options to more veterans
  • Urgent care changes that gave veterans quicker, easier access to urgent care facilities
  • Establishment of the Asset and Infrastructure Review Commission, whose job it would be to study VA facilities and services to find ways to streamline and improve the department

Most significant among the VA MISSION Act’s components was the creation of new eligibility standards for accessing non-VA care.

Under the Veterans Choice Program, the standards for accessing community care were restrictive and impractical. Vets could only access non-VA care if:

  • They had to wait longer than 30 days to get an appointment at a VA facility, for any type of care
  • They had to drive more than 40 miles to the closes VA facility. This standard was particularly burdensome because the closest VA facility might not offer the services a veteran was looking for, but the veteran would still be locked in to being under 40 miles from a VA.

The VA MISSION Act required new access standards which would expand care out to more veterans by shortening the wait time and distance thresholds and focusing on specific kinds of care. Now, veterans can access non-VA care if:

  • The wait time for a primary or mental health care appointment is longer than 20 days
  • The wait time for a specialty care appointment is longer than 28 days
  • The drive time to a primary or mental health care appointment is longer than 30 minutes
  • The drive time to a specialty care appointment is longer than 60 minutes
  • The VA does not offer the services the veteran needs
  • Community care is in the best interest of the veteran

The VA MISSION Act and these new eligibility standards empowered veterans with more flexibility and choice over where they could seek their medical care. But that doesn’t mean there haven’t been hurdles in adhering to the law.


VA MISSION Act & Veterans Health Care Reform Under Threat

At the onset of COVID-19, the VA essentially shut down access to non-VA care in violation of the VA MISSION Act.  The VA canceled or delayed nearly 20 million appointments in the first year of the pandemic. Many of those appointments didn’t have any indication in the VA’s records that they had been rescheduled.

Meanwhile, the VA continues manipulating wait times, attempting to keep vets from seeking the non-VA care they earned. Americans for Prosperity Foundation found through a Freedom of Information Act request that the VA is using confusing and inaccurate calculations for determining appointment wait times, meaning veterans aren’t being offered community care they are legally entitled to.

But despite all the attempts to skirt the VA MISSION Act, it remains a landmark piece of legislation focused on giving more veterans access to much needed health care options.

The VA MISSION Act expanded access to care for veterans, including to community care providers. Read more about a veteran who found care that worked for him in the community.